Secreting Germ Cell Tumors of the Central Nervous System: A Long-Term Follow-up Experience
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Le résumé fourni par la source
INTRODUCTION: Due to the rarity of nongerminomatous germ cell tumors (NGGCT) with non-standard treatment as yet, we report retrospectively our 30 year experience with chemotherapy followed by craniospinal irradiation (CSI), plus a boost of whole ventricular irradiation (WVI)/tumor bed (TB), tailored to pre-radiation chemotherapy response. METHODS: Between 1988 and 2016, 28 patients received four cycles of PEB (cisplatin/etoposide/bleomycin), then CSI, and two further PEB cycles. Between 1988 and1994, CSI was 25.5 Gy for patients in complete remission (CR), 30 Gy if in partial remission (PR) or metastatic, with a boost to TB up to 45-54 Gy. In the period of 1995-2010, the boost included WVI and any extra-ventricular tumor sites up to 45 Gy. After 2010, CSI was reduced to 25.5 Gy for all non-metastatic patients, and a boost was given only to TB up to 40.5/45.5 Gy, depending on patients' CR/PR status. After 2003, patients with alfafetoprotein (αFP) > 1000 ng/mL received intensified treatment, also including autologous stem cell transplantation. RESULTS: Among 28 patients (23 males; median age 12 years, 6 metastatic), 25 responded to PEB, and three progressed (PD) after one to four cycles; 26 received radiotherapy obtaining 13 CR, 7 PR and 5 stable disease (SD), 1 PD; 6 (21%) died (5 for disease, 1 for pneumonia while in CR). Five-year overall survival (OS) and progression-free survival (PFS) were both 81%; 10 year OS and PFS 81% and 76%, respectively (median follow-up 11 years). CONCLUSIONS: Survival for children with NGGCT, independently from disease extent, was encouraging. Further studies should elucidate which patients could benefit from reduced volume and dose irradiation.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Secreting Germ Cell Tumors of the Central Nervous System: A Long-Term Follow-up Experience
- Date Crossref
- 21/09/2020
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Fondazione IRCCS Istituto Nazionale dei Tumori pays non établi dans la noticeÉtablissement de santé
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IRCCS Eugenio Medea pays non établi dans la noticeStructure de recherche
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University of Milan Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Ospedale San Paolo pays non établi dans la noticeÉtablissement de santé
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Sapienza University of Rome pays non établi dans la noticeUniversité ou école supérieure
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Pediatric Oncology Unit pays non établi dans la noticeInstitution
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Pediatric Radiotherapy Unit pays non établi dans la noticeInstitution
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Neuro-Oncological Unit and Neuropsychological Rehabilitation Unit Scientific Institute pays non établi dans la noticeStructure de recherche
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Nuclear Medicine Unit pays non établi dans la noticeInstitution
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University Sapienza of Rome Department of Radiological pays non établi dans la noticeUniversité ou école supérieure
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Clinical Epidemiology and Trial Organization Unit pays non établi dans la noticeÉtablissement de santé
Fondazione IRCCS Istituto Nazionale dei Tumori, IRCCS Eugenio Medea et Department of Pediatrics — University of Milan, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.